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Bradby, H. Medicine, Health and Society . London : Sage , 2012 , 200 pp £34.99 (pbk) ISBN : 9781412920742 , £75.00 (hbk) ISBN : 9781412920735 , Ebook ISBN : 978144625843

In reading Medicine, Health and Society I felt as though an extremely knowledgeable and engaging guide was leading me through the sociological landscape of health, illness and medicine. Across a prologue and eight chapters, Bradby covers the depth and breadth of the field, while remaining accessible, concise and absorbing. The author begins by highlighting the reflexive and critical nature of the discipline and adopts such an approach herself. This is illustrated, for example, by her warning that as much material is omitted from the book as is included. Readers new to the sociology of health, illness and society will be left with a very good understanding of its key insights and contributions and will appreciate the glossary of terms; while those already familiar with the discipline will gain a new appreciation of its richness and its possibilities.

The prologue and first two chapters helpfully situate current practices and debates within the historical context by providing an overview of medical sociology’s origins, significant developments, notable contributors and theories. Bradby emphasises that sociology has been marked by ongoing tensions, for example, in its efforts both to reform and critique medicine and its attempts to study empirically health and illness and pursue social justice. She also notes that the terrain has shifted over time so that individuals currently studying cultural dimensions of health and illness come from an array of disciplines and sub-disciplines. While this move toward interdisciplinarity and multidisciplinarity may deepen our understading, it also provokes concern about sociology’s status and future as a discipline in its own right.

Having skilfully set the scene, Bradby spends the remainder of the text surveying three main research areas: inequalities in health; bodies, illness, pain and suffering; and the organisation of healthcare. Her intent is ‘to assess the ongoing significance and likely future directions of the field’ (p.18). She does in fact successfully and convincingly achieve these aims. Before focusing on specific examples of structural inequality, the author critically considers issues around defining, measuring and explaining inequality. Although Bradby does not signpost socio-economic inequalities in the same way she identifies gender, ethnic and racial inequalities, she does examine key research and interpretations within this domain. However, the omission of Richard Wilkinson and Kate Pickett’s influential and controversial book The Spirit Level, is perplexing. Although some of Wilkinson’s earlier work is cited, The Spirit Level’s claims and the reactions to them would have strengthened and deepened Bradby’s analysis of socio-economic health inequalities, particularly her discussion on global inequality.

The chapter on gendered inequality considers a range of pertinent issues including the influence of feminism on medical sociology. The author makes the important point that while feminism challenged binary gendered divisions and helped to redress sociology’s neglect of sexism within medicine, polarised representations of gender have today been re-inscribed through practices such as the over-representation of women as research subjects in particular areas including depression and reproductive healthcare.

While each chapter in this book is strong, the one exploring ‘ethnicity, racism and difference’ stands out as an exceptional synthesis of relevant material, perhaps reflecting Bradby’s own expertise in this area. The comparisons between the UK and USA help to illustrate the impact of politics and policy upon ethnic and racial inequalities in health; and a close examination of research attempting to measure the relationship between ethnicity and health demonstrates how such work has tended to reify socially constructed categories and thus encourage, rather than challenge, reductionist understandings of difference.

The section on the embodied experience of illness, disability and pain makes the point that while sociological work on suffering as a structural problem has been important in bringing into focus inequality, injustice and violence it has sidelined the corporeal and subjective aspects of painful ill-health and disabilities. The use of narrative as a means of remedying this marginalisation is explored, including critiques that such an approach is insufficiently critical and over-romanticises the patient. Bradby cleverly uses Gunther von Hagens’ Körperwelten/Body Worlds exhibition and the Visible Human Project to illustrate important but difficult concepts and to demonstrate the relevance of sociological theory to contemporary social practices.

The longest chapter addresses a range of sociological work exploring the organisation of medicine and the relationship between policy and medical practice. Bringing this disparate body of work together, Bradby argues that while medicine has been at the heart of modernism and instrumental in moving society towards post-modernity, the future shape and impact of medicine is uncertain.

Upon reaching the conclusion, I felt that I had a much better hold on current debates in the sociology of health and illness and my enthusiasm for the discipline was re-ignited. My only very slight criticism overall is that some discussions were unsupported with references. This minor niggle aside, the book is essential reading for anyone interested in medical sociology. Its greatest contribution is in providing a rich, engaging and accessible synthesis of past and contemporary developments in the sociology of health and illness. It will appeal to undergraduate and graduate students, researchers, lecturers, and health practitioners.

Reference

  1. Top of page
  2. Reference
  • Wilkinson, R. and Pickett, K. (2010) The Spirit Level: Why Equality is Better for Everyone . London: Penguin.